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KMID : 1099620170140040143
Korean Journal of Spine
2017 Volume.14 No. 4 p.143 ~ p.147
Comparison of Cervical Alignment and Clinical Outcomes in Patients with Os Odontoideum versus Non-Os Odontoideum after Atlantoaxial Fixation
Yudoyono Farid

Kang Ji-In
Ha Yoon
Abstract
Objective: The purpose of this study was to compare the effect of atlantoaxial fixation on cervical alignment and clinical outcomes in patients with os odontoideum (OO) versus non-os odontoideum (non-OO).

Methods: A total of 119 patients who underwent atlantoaxial fixation for instability were identified between January 1998 and January 2014. Inclusion criteria included age more than 21 years and diagnosis of OO and non-OO. There were 22 OO patients, and 20 non-OO patients. Measuring the Oc?C1 Cobb angle, C1?2 Cobb angle, C2?7 Cobb angle, and C2?7 sagittal vertical axis (SVA) was assessed. Clinical outcome was assessment of suboccipital pain was determined using a visual analogue scale (VAS), and Japanese Orthopedic Association (JOA) scores were obtained in all patients pre- and postoperatively.

Results: The preoperative C1?2 angle in the OO group (26.02¡Æ¡¾10.53¡Æ) was significantly higher than the non-OO group (p=0.04). After C1?2 fixation, the OO group had significantly higher kyphotic change in the C1?2 angle (¥ÄC1?2) (3.2¡Æ¡¾7.3¡Æ [OO] vs. ?1.46¡Æ¡¾7.21¡Æ [non-OO]) (p=0.04), and higher decrease in postoperative C2?7 SVA (¥ÄC2?7 SVA) (5.64¡¾11.56 mm [OO] vs. ?0.51¡¾ 6.57 mm [non-OO]) (p=0.04). Both groups showed improvements in the health related quality of life (HRQOL) after surgery based on the VAS and JOA score (p<0.001).

Conclusion: After fixation, kyphotic angular change in atlantoaxial joint and decrease C2?7 SVA were marked in the OO group. Both the OO and non-OO groups improved in neurological function and outcome after surgery.
KEYWORD
Os odontoideum, Atlantoaxial instability, C2 vertebra, Vertebra axis, Cervical, Atlantoaxial fusion
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